Information for Clinicians
How will I benefit if I am a Most Responsible Provider associated with a Home Clinic?
Clinicians fulfilling the role of Most Responsible Provider for Home Clinics are expected to benefit in a variety of ways. These include:
- Enrolment firms up the relationship not only between a patient and the Home Clinic, but also your relationship to the patient;
- Defining your patient population supports your efforts to better understand the specific needs of that population;
- Participation in future episodic information sharing (refer to Future Direction: Episodic Information Sharing for more information) will benefit from improved continuity of information related to your enrolled patients from episodic care providers they visit;
- You will be able to take advantage of valuable reports provided by MHSAL. Refer to the Home Clinic Reporting list for details;
- If using an EMR product in which the Primary Care Quality Indicator Reminders are implemented in addition to the Primary Care Data Extract, you can benefit greatly from the reminders. They are a valuable asset that helps a provider manage the considerable number of tests and procedures that underpin quality preventative care and chronic disease management for their patients; and
- If you are a fee-for-service family physician, you are eligible to claim the Comprehensive Care Management tariffs for enrolled and qualifying patients.
Can a Most Responsible Provider be associated with more than one Home Clinic?
Yes. A Most Responsible Provider who practices at multiple clinics may be associated with more than one Home Clinic.
If an episodic provider takes on the responsibility for continuous, comprehensive care for some of their patients, can they be a Most Responsible Provider?
Yes. If a family physician or nurse practitioner takes the lead role and medico-legal responsibility and provides continuous, comprehensive care for any of their patients, they are eligible to fulfil the role of Most Responsible Provider for those patients. They would not be eligible to be the MRP for patients to whom they provide only episodic care.
Who decides which enrolled patients are associated with a Most Responsible Provider?
The association process is managed within the Home Clinic. In some cases, it is a mutual agreement between the patient and the MRP. In others, the Home Clinic may make the association based on their ability to infer a relationship and identify the provider who is most responsible for an enrolled patient through analysis of EMR data.
Can an enrolled patient be assigned to or associated with more than one MRP?
No. Each enrolled patient may only be associated with one MRP. This ensures that there is a designated provider with the lead role and medico-legal responsibility for overseeing patient care within the Home Clinic and for coordinating care required from healthcare providers outside the Home Clinic. However, this does not preclude patients from seeking episodic care when required.
Does the MRP receive compensation for enrolling patients or being the MRP associated with an enrolled patient?
There is no compensation for the act of enrolling a patient for either the MRP or the Home Clinic. Providers should not schedule separate appointments to conduct active patient enrolment discussions.
Fee-for-service family physicians may claim a CCM tariff for enrolled and qualifying patients. Refer to the FAQ on the Primary Care website for more information about the tariffs.
Is there any requirement for the MRP to see the patient at specific intervals, for example, to maintain the MRP relationship?
There are no specific requirements related to enrolment. Frequency of patient and provider interaction should be based on the primary care quality guidelines and the individual patient's health and medical needs.
Does a fee-for-service family physician need to be associated with a Home Clinic to claim the Comprehensive Care Management (CCM) tariffs?
Yes. Being associated with a Home Clinic is voluntary, but it is necessary in order for a fee-for-service family physician to enrol patients and subsequently submit CCM tariff claims to MHSAL. For more information about CCM tariffs, visit Manitoba’s Primary Care website.
If a patient declines to enrol with the Home Clinic, can a fee-for-service Family Physician or General Practitioner still claim the CCM tariff?
No. CCM tariffs may only be claimed for enrolled patients for whom the Family Physician or General Practitioner has provided the patient ongoing comprehensive primary care during the preceding 12 months. For more information on the CCM tariffs, refer to the Primary Care website.
If patients are not enroled prior to April 1, 2017 can a Family Physician or General Practitioner still claim the Comprehensive Care Management (CCM) tariff?
There is no deadline to register as a Home Clinic or enrol patients. The patient must be enrolled as of the service date of the CCM tariff claim being made, and the Family Physician or General Practitioner must have provided the patient with ongoing, comprehensive primary care during the preceding 12 months. For more information on the CCM tariffs, refer to the Primary Care website.
Can a MRP sever their relationship to an enrolled patient? If so, what steps should be taken?
The rules and guidelines stipulated by the College of Physicians & Surgeons of Manitoba (CPSM) related to severing a relationship with a patient would apply to patients for whom you are the Most Responsible Provider. If for some reason the Home Clinic or MRP determines it is necessary to change the MRP for a particular patient or group of patients, the Home Clinic should advise the patient(s) of their options.
What is the impact to me if another MRP associated with my Home Clinic leaves, and we do not have another MRP available to manage thier patients?
Managing enrolled patients during these times is a not the responsibility of an individual provider. Home Clinics should first evaluate the needs of the enrolled patients with no current MRP association, and collaborate with their Regional Health Authority and the Family Doctor Finder Primary Care Connector(s) in the region to determine how best to meet the needs of these patients.
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